Provider Demographics
NPI:1639138811
Name:VAN AUKEN, STEVEN B (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:B
Last Name:VAN AUKEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 W MARKET ST
Mailing Address - Street 2:SUITE 440
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-7004
Mailing Address - Country:US
Mailing Address - Phone:330-867-7332
Mailing Address - Fax:330-867-9570
Practice Address - Street 1:1655 W MARKET ST
Practice Address - Street 2:SUITE 440
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-7004
Practice Address - Country:US
Practice Address - Phone:330-867-7332
Practice Address - Fax:330-867-9570
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3264103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0522232Medicaid
OH0522232Medicaid